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S84 Rev. July 2011 STARK COUNTY & FAMILY SERVICES Children Services Division 221 3rd Street SE Canton, Ohio 44702 REPORT FORM ABUSED/NEGLECTED CHILD REPORT TO MAKE A REPORT TELEPHONE: 455KIDS or 1800233KIDS
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How to Fill Out a Report Form for an Abused or Neglected Child:

01
Start by gathering all relevant information about the child involved, including their name, age, and any identifying details or marks.
02
Provide specific details about the abusive or neglectful situation, such as dates, times, and locations where incidents occurred, along with any witnesses or individuals involved.
03
Clearly describe the signs or evidence of abuse or neglect that you have observed, including physical injuries, emotional distress, or any other indicators that support your concerns.
04
Use factual and objective language when describing the events or circumstances, avoiding any personal opinions or assumptions.
05
Follow any guidelines or protocols provided by the reporting agency or organization to ensure accuracy and completeness in completing the report form.
06
Provide your own contact information, including your name, phone number, and address, in case further clarification or investigation is required.

Who Needs a Report Form for an Abused or Neglected Child:

01
Individuals who come into contact with a child they suspect is being abused or neglected are required to file a report. This includes professionals in education, healthcare, social work, and law enforcement, as well as any concerned citizens.
02
Teachers, school counselors, and school administrators should utilize the report form if they have reason to believe a child is being abused or neglected.
03
Healthcare providers, such as doctors, nurses, and therapists, who identify signs of abuse or neglect in a child should also complete a report form.
04
Social workers and child protective service workers have a responsibility to complete report forms when they encounter cases of suspected abuse or neglect.
05
Law enforcement personnel should utilize report forms to document their findings and suspicions when investigating cases of child abuse or neglect.
06
Any concerned citizen who witnesses or suspects abuse or neglect has the obligation to report their concerns through the appropriate channels, including completing a report form if required by their jurisdiction.
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The report form for an abused neglected child is a document used to report suspected cases of child abuse or neglect to the appropriate authorities.
Certain professionals, such as teachers, doctors, and social workers, are mandated reporters and must file a report form for an abused neglected child if they suspect abuse or neglect.
To fill out a report form for an abused neglected child, the mandated reporter must include detailed information about the suspected abuse or neglect, the child's personal information, and any other relevant details.
The purpose of the report form for an abused neglected child is to ensure that incidents of child abuse or neglect are properly investigated and addressed by the appropriate authorities.
The report form for an abused neglected child must include details about the suspected abuse or neglect, the child's name and age, the names of the child's parents or guardians, and any other pertinent information.
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